“We suspect that there are different underlying causes that lead to the clinical syndrome of asthma, so different treatment approaches are likely needed depending on what type of asthma a patient has,” she said. “A one-size-fits-all strategy might not, in fact, work for everyone.”

For the Phase IIa trial, the researchers assessed asthma patients who: were taking moderate to high doses of inhaled steroids and airway-opening drugs called long-acting beta agonists; and had high counts of eosinophils, a kind of white cell usually associated with allergy. For 12 weeks, 52 participants received weekly injections of a placebo and 52 others received weekly injections of dupilumab, a monoclonal antibody that inhibits the activity of signaling molecules involved in inflammation. After four weeks, both groups stopped using their long-acting beta agonist. Between the sixth and ninth weeks, they gradually stopped taking the inhaled steroid.

Three patients in the dupilumab group (5.8 percent) had asthma attacks compared to 23 (44.2 percent) in the placebo group, a reduction of 87 percent. The experimental agent was associated with lower levels of biomarkers of inflammation. Minor irritation at the injection site and of the nose and throat, headache and nausea occurred more frequently in the dupilumab group.

“Our findings suggest that dupilumab holds promise for the treatment of moderate-to-severe asthma,” Dr. Wenzel said. “However, further studies are needed to better define the patients who will do the best with this new approach, as well as longer-term efficacy and safety.”

Added Mark Gladwin, M.D., chief of PACCM: “A major focus of our Division of Pulmonary, Allergy and Critical Care Medicine at the University of Pittsburgh is personalized or precision medicine, which aims to match a specific treatment to a specific disease, the right approach for the right person. This study highlights the potential of targeting specific molecular pathways in the right patient with asthma.”

Gladwin, Kaminski Awards

The American Thoracic Society, at its International Conference 2013 Awards Session in Philadelphia on Sunday, May 19, presented 12 awards to the leading pulmonology clinicians and researchers. Two of its four honorees for Recognition for Scientific Accomplishments are leaders from the Pitt/UPMC PACCM programs.

Honor for Pitt Student’s Research

For the project, 450 tobacco-exposed patients were given a variety of depression and COPD tests. The researchers found that 49 of 215 (22.8 percent) female participants and 37 of 235 (15.7 percent) of male participants were depressed. Depressive symptoms were most strongly associated with: higher levels of interleukin-6, a biomarker of systemic inflammation; lower than expected forced expiratory volume, which is the maximal amount of air that can be exhaled in one second; female sex; and current smoking status.

“Depression has been linked with a number of symptoms and co-morbidities in COPD patients,” said student researcher Hilary Strollo, M.S., a graduate of Pitt’s School of Health and Rehabilitation Sciences, who is set to present this research project at the meeting at 3:15 p.m., Wednesday, May 22. “Our findings add evidence of a strong relationship between depression and one of the hallmarks of COPD - systemic inflammation – independent of the severity of the disease.”

Ms. Strollo is scheduled to attend an 11:15 a.m. news conference today, May 21, focusing on a handful of research presentations at the annual meeting. The events are held in the Pennsylvania Convention Center in Philadelphia.

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